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									 The Warwickshire Strategy for
Reducing Alcohol Related Harm

      2009/10 - 2010/11




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Foreword
Alcohol is the most widely used mood-altering substance in the UK and
consuming alcohol gives pleasure to people and economic benefit to
economies. However, when used irresponsibly it can cause immense harm to
users, their families, friends and communities. Indeed, alcohol’s harms are so
varied that it is impossible to determine whether alcohol is primarily an issue
of health, social care or community safety.

In 2005 Warwickshire developed its first, multi-agency Alcohol Strategy,
taking its lead from the government’s new Alcohol Harm Reduction Strategy
for England. The new strategy resulted in greater cooperation and joined-up
working between Warwickshire partners and ensured alcohol was firmly on
the agenda of local agencies.

In 2007 the government published their new national strategy entitled: ‘Safe,
Social, Sensible’. In response to that, and to ensure continued ongoing work
in the county, I am pleased to present Warwickshire’s new, revised alcohol
strategy for 2009/10 – 2010/11.

This strategy was approved by Warwickshire Safer Communities Partnership
at its meeting of 22nd May 2009.

Warwickshire’s revised strategy is timely as people in the UK, including
Warwickshire, continue to drink above the safe limits, which causes problems
to their health and negatively contributes to a range of society’s problems
such as anti-social and/or abusive behaviour.

I am pleased that this revised strategy has been produced and has been
informed by what matters most to the people of Warwickshire as we aim to
ensure that communities and partnership agencies have a collective focus on
reducing the harm caused by alcohol, thereby making Warwickshire the safest
place to live, work and visit.



Cllr Richard Hobbs
Chair WSCP




                               Page 2 of 15
Executive Summary

This strategy aims to reduce alcohol-related harm to individuals, families
and communities in Warwickshire through:

   •   Education and Prevention
   •   Treatment and aftercare
   •   Local enforcement of alcohol-related legislation

The strategy forms part of the Warwickshire Local Area Agreement (LAA)
which aims to create healthier and safer communities.

In line with national government policy Warwickshire will focus on three
groups:
   1) Young people under 18 and in particular between 11-15 years of age
   2) Young adults, especially 18-24 year-old binge drinkers
   3) Harmful drinkers, whose patterns of drinking damages their physical
      and/or mental health

The strategy will be delivered by all the partners represented on the
Warwickshire Safer Communities Partnership (WSCP) as well as a
number of other stakeholders.

Warwickshire Safer Communities Partnership (WSCP) will take the lead
on overseeing this strategy. Monitoring the strategy will be the
responsibility of the Drug and Alcohol Management Group (DAMG).
Ensuring the implementation of actions to deliver the strategy will be the
responsibility of the DAMG or a sub-group nominated by the DAMG.

The success of the strategy will be measured through a performance
management framework detailed within the LAA implementation plan.
This mechanism will include measurements of inputs, operational outputs
and strategic outcomes.




                               Page 3 of 15
1.    INTRODUCTION
Though many of us drink alcohol and never experience any problems,
concern about alcohol misuse is rising. From town-centre violence to teenage
pregnancy, domestic abuse and long-term health problems, alcohol seems to
be prevalent across many of society’s ills. A survey in 2000 conducted by
MORI for the Portman Group found:
       Seven in 10 people think the UK would be a ‘healthier and better place
       to live’ if the amount of alcohol consumed was reduced
       Most people (78%) perceive alcohol to be more damaging to health
       than illegal drugs
       Most people (80%) think more should be done to tackle the level of
       alcohol abuse in society
       Four in ten (40%) would like more information about the risks of alcohol
Warwickshire recognises that the only way to tackle and reduce alcohol-
related harm is through a coordinated, multi-agency approach and therefore
has devised a multi-agency strategy.


1.1    Definition of Alcohol-Related Harm
Alcohol misuse primarily relates to harm in two ways:
a) Though harm to individuals’ physical health, mental health and wellbeing
and the effect of this on their families, and
b) Through harm to communities through anti-social behaviour, crime and
disorder

Harm to the Health and Wellbeing of Individuals

There are a number of ways in which alcohol misuse can cause injury and
illness to people. When under the influence of alcohol people are more likely
to trip, fall or in some way injure themselves.

In addition to short term injuries, the long term health of drinkers can also
suffer. Excessive drinking increases the risk of heart disease and cancers,
such as breast cancer. Cirrhosis of the liver is a serious consequence of over
drinking. At its most serious, alcohol can cause premature death.

Alcohol is also closely linked to mental health and behavioural problems, and
people who have both mental health and alcohol problems are more likely to
experience problems with employment, housing and relationships.

Alcohol consumption is also associated with teenage pregnancy and the
spread of sexually transmitted diseases, and there are health issues for
women who drink during pregnancy.




                               Page 4 of 15
Harm to Communities Caused by Anti-Social Behaviour, Crime and
Disorder

While alcohol in itself does not “cause” people to act in a particular way or
behave in a particular way, excessive drinking is related to certain behaviours.
Domestic abuse, sexual violence, town-centre violence and anti-social
behaviour are all associated in varying degrees with people who are
intoxicated on alcohol.

Though some crime and disorder is strongly associated with young people
(e.g. anti-social behaviour and town-centre violence), a large proportion of
alcohol-related violence and abuse is committed by adults. It is also important
to remember that young people are often the victims of alcohol-related
violence and abuse, not the perpetrators.

The cost to the taxpayer of dealing with alcohol-related crime and disorder is
considerable, as is the extent to which this behaviour negatively impacts upon
the quality of life of others.

1.2        The Policy Framework
There are a number of pieces of legislation and guidance and a range of
different policies which impact upon alcohol policy and alcohol misuse. Some
of these drivers are national, some are local.
National      Safe, Sensible, Social: The next steps in the National Alcohol Strategy
              (2007)
              ‘Delivering safer communities: guidance for crime and disorder reduction
              partnerships and community safety partnerships’ Home Office (2008)
              Every Child Matters: Change for Children, Young People and Drugs.
              Dept for Education and Skills (2005)
              Youth Alcohol Action Plan, Department of Health (2008)
              Youth Crime Action Plan (2008)
              Guidance for developing a drug and alcohol policy: A business tool for
              employers’ Home Office (2006)
              Tackling Violent Crime Action Plan (2008)
              Working with Alcohol Misusing Offenders: Strategy for Delivery (NOMS,
              2006)

Local         Local Area Agreement - the ‘Safer’ block for Warwickshire
              Healthier Communities and Older People’s block of LAA
              Children and Young People’s Plan
              Warwickshire Police Violence Reduction Strategy
              CDRP plans and strategies
              Corporate Parenting Strategy
              Wasted - Review of young people and alcohol misuse in Warwickshire
              Joint Strategic Needs Assessment



                                Page 5 of 15
1.3      The National Strategy: ‘Safe, Sensible, Social’

Of all the above strategies and guidance, the most pertinent is the
government’s ‘Safe, Sensible, Social’ national alcohol strategy which was
launched in 2007. The overall aim of the strategy is:

“To minimise the health harms, violence and anti-social behaviour associated
 with alcohol, while ensuring that people are able to enjoy alcohol safely and
                                 responsibly.”
                                                   Safe, Sensible, Social (2007)
The national strategy aims to deliver three things:
      1) To promote an environment which encourages sensible drinking
         through investment in better information and communications
         (Education and Prevention)
      2) To ensure there is a greater focus on the minority of drinkers who
         cause or experience most harm to themselves, their communities and
         their families (Treatment and Aftercare)
      3) To ensure that the laws and licensing powers in the UK protect young
         people and bear down on irresponsibly managed premises and are
         being used widely and effectively (Enforcement)

‘Safe, Sensible, Social’ identifies three groups that it wants to focus on:
      1) Young people under 18 and in particular between 11 - 15 years of age
      2) Young adults, especially 18-24 year-old binge drinkers
      3) Harmful drinkers, whose patterns of drinking damages their physical
         and/or mental health

Finally, it states what three outcomes the strategy hopes to achieve:
      1) A reduction in the levels of alcohol-related violent crime, disorder and
         anti-social behaviour
      2) A reduction in the public’s perceptions of drunk and rowdy behaviour
      3) A reduction in chronic and acute ill health caused by alcohol, resulting
         in fewer alcohol-related accidents and hospital admissions




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2.     CURRENT SITUATION
2.1.   The National Picture


       In England, 90% of people drink alcohol.
       The cost that damage to health, crime and disorder, and the loss of
       work productivity resulting from alcohol misuse cost around £20bn per
       year in England and Wales.
       The UK now has among the highest incidences of youth drunkenness
       among European countries.
       More young people are choosing not to drink; the number of young
       people who have ‘ever tried alcohol’ decreased from 61% in 2003 to
       54% in 2007
       Among young people who drink, the average amount consumed by 11-
       15yr olds has increased substantially in the last 17yrs for both boys
       and girls
       Young people aged 16-24 are significantly more likely than people in
       other age groups to consume more than twice the recommended
       sensible drinking limit.
       Data collected suggests that nearly half of underage drinkers obtain
       their alcohol from their parents (48%). Other sources were friends
       (29%) and bars/pubs (22%).
       Despite violent crime falling, surveys show that there is an increase in
       the proportion of the public who perceive crime and disorder is rising.
       Over half of mothers report drinking during pregnancy.
       Drinking over the sensible drinking guidelines is more common in areas
       of high deprivation, with ONS data indicating that alcohol-related
       deaths are about 45% higher in areas of high deprivation.
       Although there has been a large reduction in the annual number of
       drink-driving deaths in the UK, from more than 1,600 at the end of the
       1970s to 560 in 2005, during the past ten years the rate of decline in all
       drink-driving casualties has slowed significantly.
       Deaths caused by alcohol consumption have doubled in the past two
       decades, with more people becoming ill and dying younger. In 2005,
       4,160 people in England and Wales died from alcohol liver disease.
       Deaths from liver cirrhosis have risen in the 25-34 age group.




                                Page 7 of 15
2.2.   The Warwickshire Picture


       Warwickshire, on the whole, performs well against a number of alcohol
       indicators released by the North West Public Health Observatory. Data
       by Primary Care Trust (PCT) shows that Warwickshire is in the top
       performing 25% of all PCTs in 11 out of 23 indicators.
       On average males in Warwickshire lose 8 months of life due to alcohol
       and females lose 3 months of life.
       Provisional Department of Heath information indicates that for 2007/08
       Warwickshire had 1,127 alcohol-related admissions per 100,000
       population (NI39). And is the lowest in the region.
       Approximately three-quarters of Warwickshire residents (380,000
       adults) consume alcohol.
       The Every Child Matters survey (2008) shows that “relatively high
       numbers of children in all age groups (ages 10-18) have consumed
       small amounts of alcohol at special times with their families”
       Approximately 7% of Warwickshire’s adult drinking population consume
       more than 30 units per week.
       One in four adults who drink class themselves as binge drinkers.
       On average, 60 offenders a year in Warwickshire undertake the Drink
       Impaired Driver Programme having been convicted of drink-driving.
       Estimates suggest there are 85,000 people aged 16+ who drink
       hazardously in Warwickshire.
       Estimates suggest there are 18,800 people aged 16+ who drink
       harmfully in Warwickshire.
       Six in ten males aged 18-24 fall into the binge-drinker category.
       Residents in the south of the county are more likely to drink than
       residents in the north and are more likely to drink more often, however
       residents in the north are more likely to binge drink.
       In 2006/7 there were 339 admissions to the George Elliott hospital
       where alcohol was a primary or secondary diagnosis; men accounted
       for 210 of those admissions with women accounting for 129.
       There were 281 admissions to Warwick hospital where alcohol was a
       primary or secondary diagnosis; men accounted for 204 of those
       admissions with women accounting for 77.
       There were 19 alcohol-related deaths in the George Elliott hospital in
       2004/5, there were 10 in 2005/6, 26 in 2006/7 and 21 in 2007/8.
       There were 10 deaths from alcoholic liver disease in Warwick hospital
       in 2003/4, 3 deaths in 2004/5 and 6 in 2005/6.




                               Page 8 of 15
3.       THE WARWICKSHIRE STRATEGY


3.1      Aim

This strategy aims to reduce alcohol-related harm to individuals, families
and communities in Warwickshire through:

      1) Education and Prevention
      2) Treatment and aftercare
      3) Local enforcement of alcohol-related legislation

3.2      Elements of Strategy
Education & Prevention

To promote an environment which encourages sensible drinking through
investment in better information and communications.

Warwickshire Safer Communities Partnership will inform and educate the
public with messages about safer drinking in an attempt to prevent and deter
young people from drinking at all, and to prevent and deter adults from
drinking above recommended limits.

Warwickshire agencies will promote the ‘Know Your Limits’ campaign and
work with partners such as Road Safety to tackle specific issues, e.g. drink-
driving. Health centres, such as GP practices, carry publicity information
about alcohol services around the county so that all residents, including older
people, know where they can access help and support.

Treatment & Aftercare

To ensure there is a greater focus on the minority of drinkers who cause or
experience most harm to themselves, their communities and their families.

Warwickshire Safer Communities Partnership will ensure that alcohol
treatment is available for those that need it. Warwickshire will provide a range
of interventions, from advice and information to counselling and detoxification.
Specialist treatment will be available for offenders whose alcohol dependency
results in being sentenced to a community penalty.

There will be equality of access to services around the county and services
will be available to both young people and adults. Services will welcome the
input and involvement of service users, families and carers. After someone
has left treatment, services will assist that person with any financial, housing,
employment or training issues that they may have.




                                 Page 9 of 15
Local enforcement of alcohol-related legislation

To ensure that the laws and licensing powers in the UK protect young people
and bear down on irresponsibly managed premises and are being used widely
and effectively.

Warwickshire Safer Communities Partnership will use all existing legislation to
deal with those caught selling alcohol to young people and to tackle violence
and anti-social behaviour fuelled by alcohol.

Warwickshire will continue to work in a positive way with the alcohol industry
to uphold the law with regard to alcohol sales and to tackle underage drinking
and those drinking irresponsibly.


3.3    Priority Groups
Partners will deliver the strategy to all sectors of society, including ‘hard to
reach’ groups, such as BME communities and people with mental health
problems. However, the Warwickshire Strategy will reflect the national
strategy in that it will prioritise the following groups:
   1) Young people under 18, and in particular between 11-15 years of age
   2) Young adults, especially 18-24 year-old binge drinkers
   3) Harmful drinkers, whose patterns of drinking damages their physical
      and/or mental health


3.4    Outcomes
Warwickshire partners are looking to see improved outcomes across both
health and crime agendas. Therefore, the outcomes of delivering the harm
reduction strategy will be:

To Reduce Harm to the Health and Wellbeing of Individuals
   1) Reduction in rate of alcohol hospital admissions (NI39)
   2) Reduction in alcohol-related accidents
   3) Reduction in young adults (18-24) drinking more than recommended
      levels
To Reduce Harm Caused by Anti-Social Behaviour, Crime and Disorder
   4) Reduction in the number of young people (10-17yrs) binge-drinking
   5) Reduction in perceptions of drunk or rowdy behaviour as a problem
   6) Reduction in alcohol-related violence, including domestic abuse and
      town-centre violence
Less tangible but equally important outcomes include stronger and healthier
families and more cohesive communities.



                                Page 10 of 15
3.6   Ownership
The Warwickshire Strategy for Reducing Alcohol-Related Harm is produced
and owned by the partners and members of the Warwickshire Safer
Communities Partnership. They are:

       Coventry and Warwickshire Partnership Trust (Health)
       Crown Prosecution Service
       HM Courts Service
       North Warwickshire Borough Council
       Nuneaton & Bedworth Borough Council
       Rugby Borough Council
       Stratford District Council
       Warwick District Council
       Warwickshire Assoc. of Youth Clubs (Voluntary & Community Sector)
       Warwickshire County Council, inc Road Safety
       Warwickshire Police
       Warwickshire Police Authority
       Warwickshire Primary Care Trust / NHS Warwickshire (Health)
       Warwickshire Probation
       Youth Offending Service (Youth Justice)


3.7    Audience
This strategy is for all the members of the Warwickshire Safer Communities
Partnership plus other stakeholders and the residents of Warwickshire.

3.8    Delivery
The Strategy will be delivered by all the partners represented on the
Warwickshire Safer Communities Partnership. Monitoring the strategy will be
the responsibility of the Drug and Alcohol Management Group (DAMG).
Ensuring the implementation of actions to deliver the strategy will be the
responsibility of the DAMG or a sub-group nominated by the DAMG. Day-to-
day strategic coordination will be provided by the Warwickshire Drug and
Alcohol Action Team based in the County Council.
In addition, delivery will be through:
          a) District plans
          b) The LAA

District Plans

The mechanism by which agencies at a district level work together in the field
of crime and disorder is the Crime and Disorder Reduction Partnerships
(CDRPs). These multi-agency partnerships formulate and implement
strategies to tackle crime and substance misuse in their areas. Each CDRP
will have its own alcohol implementation plan which will address local needs
and concerns.




                              Page 11 of 15
Local Area Agreement

The Local Area Agreement (LAA) provides an important mechanism for
delivering the long term outcomes to reduce the harm caused by alcohol. The
LAA is a partnership agreement signed by all the key partners and Central
Government. This agreement includes 35 agreed priorities and, whilst some
of these are specific to alcohol, many reflect the cross cutting nature of
partnership working.

The Warwickshire LAA is set out within six strategic themes, one of which is
the Safer Block. The delivery of the actions relating to alcohol are the
responsibility of Warwickshire Safer Communities Partnership.



Further Reading

Safe, Sensible, Social: The next steps in the National Alcohol Strategy (2007)
Delivering safer communities: guidance for crime and disorder reduction
partnerships and community safety partnerships. Home Office (2008)
Every Child Matters: Change for Children, Young People and Drugs. Dept for
Education and Skills (2005)
Youth Alcohol Action Plan. Department of Health (2008)
Guidance for developing a drug and alcohol policy. A business tool for
employers. Home Office (2006)
‘Wasted’ – Review of young people and alcohol misuse in Warwickshire
(2007)
Warwickshire Joint Strategic Needs Assessment (JSNA), Warwickshire NHS
& WCC, (2008)
Corporate Parenting Strategy, WCC



Contact
If you would like more information regarding this strategy, please contact Kit
Leck, Drug and Alcohol Action Team Strategy Manager on 01926 746808 or
email kitleck@warwickshire.gov.uk




                               Page 12 of 15
Warwickshire Alcohol Harm Reduction Strategy 2009-11
Addendum




Summary
In 2005 Warwickshire developed its first, multi-agency Alcohol Strategy,
taking its lead from the government’s Alcohol Harm Reduction Strategy for
England. In 2007 the government published the next phase of the strategy
entitled: ‘Safe, Social, Sensible: The Next Steps in the National Alcohol
Strategy’.
During 2008/9 the national and regional government undertook two important
consultation exercises and reviews into alcohol consumption, sales and
supplies. The first was called, ‘Is the West Midlands drinking itself to death?’,
the second was, ‘How alcohol is sold and supplied’.
In response, and to ensure continued ongoing work in the county,
Warwickshire developed a new, revised alcohol strategy for 2009/10 –
2010/11.
The Warwickshire Strategy is supported by a comprehensive implementation
plan that builds upon the successes and gaps identified during the lifetime of
the previous strategy and recognises that local communities are best placed
to identify local problems including alcohol-related disorder.
A key change has been an increased emphasis upon early intervention,
health promotion and reduction in alcohol-related crime and disorder.
The implementation plan will be reviewed each quarter during 2009-10 with a
new plan being prepared for subsequent years.


What has changed?
The population of Britain as a whole is drinking more than ever before, leading
to a range of health, social and law and order problems.
Hospital alcohol-related admissions which gone up significantly during the last
five years with Warwickshire seeing an approximate rise of 63% between
2002/3 and 2007/8.
Young people aged 16-24 years are significantly more likely than people in
other age groups to drink more than twice the recommended sensible drinking
limit and the repercussions are clearly evident. Female binge drinkers are
nearly three times more likely to be involved in a violent incident. Male binge
drinkers are twice as likely to be involved in a violent incident than their
sensible drinking counterparts.
Alcohol misuse is clearly a feature of violent crime with more than 40% or
recorded violent crime having an alcohol implication.
Whilst overall serious violent crime fell in Warwickshire in 2008/09, the
number of offences of most serious violence (National Indicator 15 within the
LAA) increased by 17.2%. It is worth noting that the recording criteria for


                               Page 13 of 15
serious violent crime were reviewed during 2008/09, with a negative impact
on the LAA measure as a greater number of offences were included within the
LAA classification. The 2009/10 LAA target has been refreshed to reflect the
new classification.
From April 2008 all Crime and Disorder Reduction Partnerships (CDRPs)
have legal responsibilities to have a strategy to tackle crime, disorder and
substance misuse (including alcohol).


Achievements to Date
The first strategy resulted in greater cooperation and joined-up working
between Warwickshire partners and ensured alcohol was firmly on the
agenda of local agencies.
Warwickshire began a range of new initiatives. The Arrest Referral Scheme
has been expanded to include alcohol as well as drugs, Swanswell is running
a new scheme for perpetrators and victims of domestic abuse who have
alcohol issues and the Probation Service is, in conjunction with Swanswell,
running and delivering an Alcohol Treatment Requirement (ATR) for
offenders.
Both these initiatives are demonstrating successful outcomes in the reduction
of offending. The alcohol and domestic violence scheme has reported that
71% of perpetrators had not re-offended and that 73% had reduced alcohol
consumption.
Swanswell Community Alcohol Service and Coventry and Warwickshire
Partnership Trust continued to provide high quality alcohol treatment to
residents and local partners worked across health and community safety
agendas to tackle alcohol misuse. Evidence of this improved joint working can
be evidenced by the number of adults being assessed and commencing
treatment and care with Swanswell commencing 1,716 treatment episodes
during 2007-09.
The Local Alcohol Profile for England (LAPE) shows that Warwickshire
performs very well overall. Across twenty-two indicators, Warwickshire is in
the top performing quartile of the country in eleven of them.


Key Performance Indicators
The Strategy aims to achieve the following:
       a) A reduction in rate of alcohol-related hospital admissions (NI39);
       b) A reduction in the level of alcohol-related accidents;
       c) A reduction in the number of young adults (18-24) drinking more
       than recommended levels;
       d) A reduction in the number of young people (10-17yrs) binge-
       drinking;
       e) Reduction in perceptions of drunk or rowdy behaviour as a problem
       and,


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         f) Reduction in alcohol-related violence, including domestic abuse and
         town-centre violence


Strategy Planning, Co-ordination and Performance Monitoring
The strategy was approved by Warwickshire Safer Communities Partnership
at its meeting in May 2009 and the Partnership has directed a strategic
partnership group to ensure that the strategy is implemented across District ,
Borough and County organisations and partnerships.
The day to day work of this group is supported by the Drug and Alcohol
Strategy Team (DAST). This team is hosted by Warwickshire County Council
and sits within the Warwickshire County Council’s strategic directorate for
Customers, Workforce and Governance.


Kit Leck
DAST Strategy Manager
Customers Workforce and Governance
Pageant House
2 Jury Street
Warwick. CV34 4EW


Tele:       01926 7468000
Email:      kitleck@warwickshire.gov.uk
Website: www.warwickshire.gov.uk/drugs




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